Examining the Role of Kratom in the Opioid Crisis

The opioid overdose crisis has reached such epic proportions that it’s been declared a nationwide epidemic, with overdose and addiction rates ravaging the country. Due to the intensity of the deadliest drug crisis that’s ever hit our country, many individuals and experts have been asking whether there may be more suitable or natural alternatives to opioid pain killers. Kratom, also scientifically known as the mitragyna speciosa plant, is a popular, tropical nootropic plant and dietary supplement native to Southeast Asia that acts like a stimulant when consumed in small doses and produces more euphoric, opioid-like effects when used in larger quantities.

Because of these qualities, many people have sought to use kratom as a method of self-medication, hoping that it will serve as a natural alternative to opioid painkillers. Many others have also questioned whether kratom might be utilized as an effective treatment for opioid addiction, or if unregulated usage may lead to even more dangerous long-term effects.

There is, however, an array of misconceptions surrounding kratom use that ought to be demystified prior to making the decision regarding whether kratom will positively or negatively impact substance abusers and the opioid crisis. Although the herbal supplement is a more natural leaf substance, many make the erroneous assumption that if something is natural that automatically means it is “safe.” While the possibility remains that kratom may have useful medicinal purposes, the fact is that it is understudied and unregulated, making it impossible to truly determine its efficacy as an opioid alternative or innocuous recreational drug.

Another factor that may draw people to utilize the supplement is that kratom capsules are also a much cheaper alternative to expensive opioid-replacement medications like buprenorphine, ranging from $10 to $40 per ounce. The American Kratom Association (AKA), an association that advocates for the use of the drug as a dietary, pain-relieving supplement, estimates that about five million people in the U.S. regularly use it.

Due to its lack of regulation, the U.S. Food and Drug Administration (FDA) urges consumers not to ingest the drug prior to a final, official determination of the clinical manifestations and side-effects. So far, no clinical trials have been conducted in order to gauge whether kratom can efficiently treat pain and opioid withdrawal symptoms. The drug is often excessively overconsumed, leading to the expression of an array of adverse and potentially dangerous side-effects, including sweating, appetite loss, elevated blood pressure, and in extreme cases seizures.

Many medical examiners have also reported deaths associated with usage of the drug, although the AKA disputes that kratom is the only drug involved in many of these incidents. Some evidence has even suggested that in rare cases kratom usage has been linked with triggering psychosis. Although the numbers of reported calls related to kratom use are relatively low when compared to other substances, the Center for Disease Control and Prevention (CDC) concluded from a study of poison center calls that kratom use has spiked significantly, and may become an emerging public health threat.

According to the limited studies conducted by the FDA so far, evidence shows that kratom affects the same brain receptors as morphine does and contains opioid compounds, and while it can be used to ease the short-term effects of withdrawal, consistent use may actually lead to long-term opioid dependence. As a result of this small amount of evidence, the FDA moved to place kratom on its list of Schedule 1 controlled substances back in 2016. This decision was placed on hold, however, after lawmakers requested that further research be orchestrated in order to have a firm grasp of all possible dangers and benefits of usage. The issue is still currently under review, with no further decisions having been made at the federal level.

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